Schwannoma including epithelial elements mimicking pleomorphic adenoma of the submandibular gland on fine-needle cytology: The first case report.

Although most salivary gland tumors can be diagnosed accurately on fine-needle aspiration, cytological evaluation of spindle cell lesions, including schwannomas, still poses a challenge. In salivary gland aspirates, the most important mimickers of schwannomas are the common pleomorphic adenomas/mixed tumors since these may yield abundant spindle-shaped myoepithelial cells and only scant epithelial cells. Therefore, in spindle cell-rich aspirates from the head and neck, diligent search for epithelial cells is recommended. Their presence traditionally favors pleomorphic adenoma and argues against a schwannoma. Herein, however, we report, for the first time, a schwannoma with epithelial elements (glandular schwannoma) in the submandibular gland, demonstrating that the presence of epithelial cells in a spindle cell-rich aspirate may not always exclude a schwannoma.